Abstract
The publication of the Thompson et al. competencies framework for pediatric palliative care marks a third set of practice guidelines published. There is essential tension between specialist training in clinical child psychology (our “home” discipline) leading to further subspecialty training in pediatric psychology, the desired balance between the two, and impact on teaching, training, and patient care. A purpose of this invited commentary is to stimulate further awareness and subsequent discussion of the integration of more narrow practice skills in a growing and developing field, as the tendency toward greater specialization and siloed practice increases.